Introduction The pathophysiology for Coronavirus Disease 2019 (COVID-19) infection is characterized by cytokine oxidative stress and endothelial dysfunction. Intravenous (IV) vitamin C has been utilized as adjuvant therapy in critically ill patients with sepsis for its protective effects against reactive oxygen species and immunomodulatory effects. The primary objective of this study was to evaluate the effects of IV vitamin C in critically ill patients with COVID-19 infection. Methods Retrospective observational cohort study with propensity score matching of intensive care unit (ICU) patients who received 1.5 grams IV vitamin C every 6 hours for up to 4 days for COVID-19 infection. The primary study outcome was in-hospital mortality. Secondary outcomes included vasopressor requirements in norepinephrine equivalents, ICU length of stay, and change in Sequential Organ Failure Assessment (SOFA) score. Results Eight patients received IV vitamin C and were matched to 24 patients. Patients in the IV vitamin C group had higher rates of hospital mortality [7 (88%) vs. 19 (79%), P = 0.049]. There was no difference in the daily vasopressor requirement in the treatment group or between the 2 groups. The mean SOFA scores post-treatment was higher in the IV vitamin C group (12.4 ± 2.8 vs. 8.1 ± 3.5, P < 0.005). There was no difference in ICU length of stay between the treatment and control groups. Conclusion Adjunctive IV vitamin C for the management of COVID-19 infection in critically ill patients may not decrease the incidence of mortality, vasopressor requirements, SOFA scores, or ventilator settings.

Tattooing is an increasing trend among Western countries, with about 18% of the population undergoing the procedure once in their lifetime. The process looks simple; introduce exogenous pigment into the dermis layer of the skin, altering the skin color permanently. However, this simple procedure leads to several health issues and medical complications, both acute and chronic, and some are difficult to cure. Sarcoidosis is high on the list of severity involving almost all body organs. Multiple organ involvement makes this condition more difficult to treat. Lungs and lymphatics are the leading sites of involvement, followed by an inflammatory disease of the eye called uveitis. An additional problem is the limited confirmatory diagnostic tests and treatment options for sarcoidosis. Each patient must be considered unique based on their age, clinical presentation, and severity of involvement. Proper treatment must be tailored for better outcomes with minimum side effects and rapid cure. Here we describe two case reports of tattoo-associated sarcoidosis with severe uveitis successfully treated with mycophenolate mofetil.

Background: I-131 (radioactive iodine (RAI)) therapy effectively targets overactivity of the thyroid gland; however, the literature provides conflicting outcomes regarding dosage optimization of I-131 for patients with hyperthyroidism and associated clinical complications. This retrospective study aimed to validate the therapeutic efficacy of an empirically derived I-131 institution formula in resolving hyperthyroidism by establishing a euthyroid or hypothyroid state.Methods: This retrospective chart review was undertaken for 89 adult patients (> 18 years) who received I-131 therapy from 2016 to 2020 at H&H/Queens, New York. The I-131 dose range was determined in accordance with their thyroid gland weight and thyroid uptake percentages; however, the follow-up assessment was performed for a duration of 6 -12 months. IRB approval with reference HS-STUDY-21-01760 was obtained. All the subjects consented using a written consent document in a private room. All the patient's data are stored confidentially in a password-protected computer, which is accessible only to the study group. The primary endpoint (i.e., treatment success) was defined by the interim development of a euthyroid state, hypothyroidism, subclinical/questionable/suspected hypothyroidism, or a questionable euthyroid state. The secondary endpoints included the frequency of repeat RAI doses and post-ablation thyroid function tests (TFTs). Results:The univariate and multivariate analysis of patient data indicated an 83% I-131 treatment success rate defined by the achievement of a euthyroid state and hypothyroidism in 6.7% and 70.8% of patients, along with the attainment of questionable euthyroid status, questionable hypothyroidism, subclinical hypothyroidism, and suspected hypothyroidism in 1.1%, 1.1%, 2.2%, and 1.1% of patients, respectively. In addition, a low number (i.e., 9%) of patients with hyperthyroidism required repeat I-131 treatment dosages to achieve a hypothyroid or euthyroid state. The results indicated a clinically significant impact of I-131 treatment dosages on post-ablation thyroid-stimulating hormone (TSH), triiodothyronine (T3), and free thyroxin (FT4) levels. Conclusion:The results of this study testified to the therapeutic efficacy of the current institution's formula for I-131 treatment dosages in treating hyperthyroidism. In addition, 83% treatment success and a low retreatment requirement strengthened current evidence favoring the optimization of RAI therapy for hyperthyroidism.